OP0154 TOPHI AND CAROTID PLAQUE WERE RISK FACTORS OF MACE IN GOUTY ARTHRITIS PATIENTS: A LONGITUDINAL COHORT STUDY
Authors: Y. Wang, Z. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with gout carry an excess risk for cardiovascular disease (CVD). However, the prevalence of subclinical arthrosclerosis and its relationship with CVD risks and events in gout have not been reported. <h3>Objectives</h3> The objective of this study is to explore whether tophi and subclinical atherosclerosis could predict incident MACE (major adverse cardiac events) in gouty arthritis patients by ultrasonography. Determine whether incorporation of imaging data could improve CV(cardiovascular) risk prediction. <h3>Methods</h3> A single-center, cohort analysis was performed to assess subclinical artheroscelrosis at baseline since 2008. Patients were excluded if they had previous diagnosed CVD or cerabral vascular disease. The outcome of study was first MACE. The presence of subclinical atherosclerosis was assessed by cartoid intima-media thickness (CMIT) and total plaque area (TPA) was determined in a subgroup of patients by ultrasound. Scan of feet and ankles was performed bilaterally by ultrasonography at baseline. The association between tophi, measurements of carotid artherosclerosis and risk of developing and incident MACE was evaluated using Cox proprotional hazards models, with adjustment for the CVD risk scores. <h3>Results</h3> A total of 262 consecutive patients with primary gout were recruited, the mean age was 44.0 years; male 260 (99.2%). After a median follow-up of 10.3 years, 32 (12.2%) had incident MACE ascertained. Cox analysis showed that more than 2 tophi was significantly associated with an increased risk of develping MACE (HR: 9.96, 95%CI 8.89-43.6, <i>P</i>=0.001). The association remained significant after adjusting for CV risk scores in the multivariable models. In subgroup analysis, 240 patients had carotid ultrasound assessment, 28 (11.7%) patients experienced a first MACE event. In cox hazards model, which controlled for the CV risk scores, more than 2 tophi (HR 2.12-5.25, <i>P&lt;</i>0.05) and and carotid plaque (HR 3.72-4.01, <i>P&lt;</i>0.05), were both independent predictor of incident MACE in patients with gout seperately. <h3>Conclusion</h3> The presence of more than 2 tophi and carotid plaque by ultrasound could independently predict MACE in addition to conventional cardiovascular risk factors in gout patients. <h3>References</h3> [1] Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol 2020;16:380–90. [2] Andrés M, Quintanilla M-A, Sivera F, Sánchez-Payá J, Pascual E, Vela P, et al. Silent Monosodium Urate Crystal Deposits Are Associated With Severe Coronary Calcification in Asymptomatic Hyperuricemia: An Exploratory Study. Arthritis Rheumatol 2016;68:1531–9. [3] Andrés M, Bernal JA, Sivera F, Quilis N, Carmona L, Vela P, et al. Cardiovascular risk of patients with gout seen at rheumatology clinics following a structured assessment. Ann Rheum Dis 2017;76:1263–8. [4] Richette P, Perez-Ruiz F, Doherty M, Jansen TL, Nuki G, Pascual E, et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol 2014;10:654–61. [5] Neogi T, Jansen TLTA, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann. Rheum. Dis. 2015;74:1789–98. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.